Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

Dr. Steven E. Olchowski performed the surgeries between December 2000 and the spring of 2002 at New Hanover Regional Medical Center, which is facing eight malpractice lawsuits stemming from the weight-loss operations.

“We cannot be sure about any conversation in Dr. Olchowski’s office between him and his patients,” Dr. Samuel Spicer, vice president of medical affairs at New Hanover Regional, said Wednesday.

The lawsuits claim Olchowski told patients he would perform a gastric bypass surgery known as Roux-en-Y, which usually is covered by health insurance. According to the lawsuits, he performed minigastric bypass, which usually is not covered.

The difference between the surgeries is how the stomach and intestines are attached.

Attorneys for six of the patients said their clients had serious complications such as stomach ulcers and required a second surgery to convert the bypass into a Roux-en-Y.

It wasn’t immediately clear how much the lawsuits sought in compensation.

Olchowski, 57, resigned from New Hanover Regional in 2003. He now practices at Ionia County Memorial Hospital in Michigan.